AB1664 INFLUENZA, PNEUMOCOCCAL, AND TETANUS VACCINE COVERAGE AMONG PATIENTS WITH INFLAMMATORY RHEUMATIC DISEASES ON BIOLOGICAL OR TARGETED SYNTHETIC DMARDS AND THE ROLE OF THE RHEUMATOLOGIST
Authors: T. Georgiev, R. Moraliyska, S. Bogdanova-Petrova, S. Dimitrov, S. Hristova, D. Simeonova, G. Gerganov, T. Shivacheva
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Vaccines are one of the most efficient tools to prevent infectious diseases at a population level. Their importance is even greater in immunocompromised patients providing efficient and safe protection against common viral and bacterial infections. According to the current EULAR recommendations based on solid evidence over the recent years, non-live vaccines such as influenza, pneumococcal, tetanus toxoid, and others are safe and can be administered to patients with inflammatory rheumatic diseases during the glucocorticoid and/or disease-modifying antirheumatic drug (DMARD) therapy. Furthermore, influenza and pneumococcal vaccines "should be strongly considered" and the tetanus toxoid vaccination should be received in accordance with the recommendations of the general population¹. <h3>Objectives</h3> We aimed to investigate the coverage for influenza, pneumococcal, and tetanus toxoid vaccination in a cohort of patients with inflammatory rheumatic diseases on biological or targeted synthetic DMARDs. <h3>Methods</h3> Two hundred and one patients, aged 18 or older, were included in this single-center cross-sectional study after signing an informed consent form. They suffered from rheumatoid arthritis (RA), psoriatic arthritis (PsA), or ankylosing spondylitis (AS) and were on biological or targeted synthetic DMARDs. Individuals with psychiatric or neurological diseases preventing understanding or responding to the questions were excluded from the study. Patients' anthropometric, clinical, and demographic characteristics were collected via detailed anamnesis and clinical examination. Disease activity was evaluated using DAS28-CRP for patients with RA and peripheral PsA and ASDAS for those with axial disease (AS and axial PsA). All patients were asked to fill in a survey determining their immunization status for influenza, pneumococcal, and tetanus toxoid vaccines and whether they had a preceeding discussion with their rheumatologist about recommended vaccines during their routine medical visits. <h3>Results</h3> Of the 201 included patients, 40.3% (n=81) were females. Patient distribution according to their disease was as follows: 30.3% (n=61) RA patients, 51.7% (n=104) AS patients, and 17.9% PsA patients (n=36). Mean age, disease duration, and body mass index values were 54.62 (14.4) years, 11.04 (8.6) years and 28.2 (5.3), respectively. 27.4% of patients were on concomitant glucocorticoid treatment. Only 13.9% (n=28) and 1.5% (n=3) were vaccinated against seasonal influenza and pneumococcal infections, respectively. Patients who had а preceeding discussion about seasonal influenza and pneumococcal immunization with their rheumatologist had approximately 13 and 32 times higher probability to get vaccinated than people who did not (OR=12.9, p &lt; 0.001 and OR 32.5, p = 0.01, respectively). Regular reimmunizations against diphtheria and tetanus according to the Immunization Calendar of the Republic of Bulgaria were carried out by only 44.8% (n=90) of the studied population. <h3>Conclusion</h3> Coverage of recommended vaccines in our group of Bulgarian patients on biological or targeted synthetic DMARDs is very low. Discussion about the potential benefits and safety profile of the recommended vaccines may increase patients' willingness to vaccinate and prevent common infectious diseases in immunocompromised rheumatic patients. <h3>Reference</h3> [1]Furer V, Rondaan C, Heijstek MW, et al. 2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. <i>Ann Rheum Dis</i>. 2020;79(1):39-52. doi:10.1136/annrheumdis-2019-215882 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.